Technical Field
Embodiments disclosed herein are related to improved visualization for vitreo-retinal, glaucoma, or other ophthalmic surgeries. More specifically, embodiments described herein relate to a microscope-less wide-field-of-view surgical optical coherence tomography (OCT) visualization system.
Related Art
Developing techniques to assist ophthalmic surgery with imaging and visualization is one of the hottest areas of development and innovation. One class of ophthalmic surgeries, the vitreo-retinal procedure, involves vitrectomy, the removal of the vitreous body from the posterior chamber to access the retina. The successful execution of vitrectomy requires an essentially complete removal of the vitreous, including the most challenging regions near the vitreous base. Using imaging techniques and devices can be of substantial help to improve the efficiency of the vitreous removal.
However, assisting vitrectomy with imaging is particularly challenging for several reasons. One of them is that the vitreous is transparent. Another challenge is that visualization of the periphery requires imaging beams with a high angle of obliqueness. Similar visualization issues exist during membrane peeling procedures. At present, typically microscope or video-microscope imaging is used to address the former challenge, and wide angle contact-based or non-contact based lenses are used to address the latter challenge, in each case with limited success.
Improvement of the imaging can be achieved by using optical coherence tomography (OCT), a technique that enables visualization of the target tissue in depth by focusing a laser beam onto the target, collecting the reflected beam, interfering the reflected beam with a reference beam and detecting the interference, and measuring the reflectance signature within the depth of focus of the beam. The result is a line scan in depth, a cross-sectional scan, or a volumetric scan.
OCT has become common practice in the clinic as a diagnostic tool. Surgeons take pre-op images into the operating room for reference. OCT scanning is currently not available in the operating room, and thus does not support decision making during surgery. Pre-op images have limited utility following morphologic modifications to the target during a procedure.
Efforts to develop real-time intra-surgical OCT systems are being made by multiple companies ranging from startups to large corporations. The approaches to intra-surgical OCT to date have been microscope-based or endoprobe-based. However, standard surgical microscopes are designed for visible wavelength and, therefore, may not provide satisfactory near-infrared (NIR) performance for OCT imaging. Accordingly, integrating OCT into standard surgical microscopes can require substantial modifications of the microscope. Further, these modifications can be microscope specific dependent on the particular features and optical elements of each microscope.
Accordingly, there is a need for improved devices, systems, and methods that facilitate real-time, intra-surgical, wide-field of view OCT imaging by addressing one or more of the needs discussed above.